Karagiannidis, C., Meissner, A., Koryllos, A., Windisch, W. and Strassmann, S. (2014). Prophylaxis and Therapy for Atrial Fibrillation after General Thoracic Surgery. Zent.bl. Chir., 139. S. S39 - 4. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1438-9592

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Abstract

Following thoracic surgery atrial fibrillation (AF) frequently occurs in 12 to 44% of cases postoperatively and is related to an increased morbidity and mortality. In 2011, the Society of Thoracic Surgeons of the United States published guidelines for the prophylaxis and treatment of postoperative AF. High evidence levels are provided for continuing beta-blocker treatment despite its known negative inotropic effects. Alternatively, the calcium channel blocker diltiazem, or amiodarone for patients without pneumonectomy are recommended for prophylactic therapy. For rate control of AF occurring post surgery, not only selective beta 1-blockers, calcium channel blockers, but also magnesium or digoxin are suitable in haemodynamically stable patients. Amiodarone, beta(1)-blockers and flecainide are preferred for rhythm control in case of haemodynamic stability in regard to possible side effects and contraindications. In contrast, electrical cardioversion is indicated in those patients with haemodynamic instability. Persistent AF of > 48 hours is a target for anticoagulation treatment depending on the individual aspects of the patient and in accordance to the CHADS2 score. The present review article further discusses the evidence for the recommended medical therapy and treatment strategies.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Karagiannidis, C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meissner, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koryllos, A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Windisch, W.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Strassmann, S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-429692
DOI: 10.1055/s-0034-1383002
Journal or Publication Title: Zent.bl. Chir.
Volume: 139
Page Range: S. S39 - 4
Date: 2014
Publisher: GEORG THIEME VERLAG KG
Place of Publication: STUTTGART
ISSN: 1438-9592
Language: German
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
OBSTRUCTIVE PULMONARY-DISEASE; RISK-FACTORS; THORACOSCOPIC LOBECTOMY; AMIODARONE; PREVENTION; EXPERIENCE; MORBIDITY; RHYTHMMultiple languages
SurgeryMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/42969

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